Objective To explore the risk management factors and preventive measures in obstetric care. Methods The implementation of risk management in our hospital was retrospectively analyzed. Results Maternal satisfaction degree was significantly increased, complaints and errors of nursing care were significantly decreased. Conclusions Strengthening of risk management in obstetric care can benefit to eliminate and prevent unsafe factors, so that obstetric care quality is improved.

Objective:To verify the applicability of Dynamic Contrast Enhanced Magnetic Resonance Imaging(DCE-MRI)to evaluate the breast cancer therapy using the high intensity focused uhrasound(HIFU).Methods:Both DCE-MRI and conventional T_1W/T_2W images were acquired for the total 8 subjects.Two consecutive scans were performed for every patient(before operation and 2 weeks after operation)while four were performed for only 2 patients(additional for 6 months and 12 months after operation).The breast cancer therapy by HIFU was assessed hy comparing the changes of signal,the dynamic patterns of time-signal intensity curve,the early-phase contrast enhancement ratios and vessel anatomies around cancer focuses.Results: The shortened T_2 signals were observed in cancer focuses of 5 subjects while 3 still showed longer T_2 values which were differentiated by the high intensity in T_2W images.The early-phase contrast enhancement ratios of those 5 subjects decreased from 60%～80% to

Objective To analyze the application of non-protective midwifery in China so as to provide a theoretic basis for the develop-ment of this technique. Methods The full-text literatures of non-protective midwifery published in China during January 2004 and January 2014 were searched and obtained in China National Knowledge Infrastructure ( CNKI) ,Wanfang Database and VIP Database via computer. All searched literatures were analyzed with the literature study method. Results Totally 21 literatures were obtained by search. They were centrally from the coastal areas and mainly the controlled studies,and focused on the comparison of non-protective midwifery vs. protective midwifery in perineal laceration,second birth course and intrapartum bleeding volume. Conclusion The literatures show that non-protective midwifery is significantly beneficial for patients,though it develops later and concentrates at partial areas. Such midwifery technique shall be popularized all around the country.

Objective To study the pharmacological action and clinical application of flavonoids.MethodsThe pharmacological effects of flavonoids were analyzed, and the related literatures were searched and analyzed.This paper describes the pharmacological action mechanism and clinical application of flavonoids, analyzes its biological activity, combined with the related structure and function, and gives a more detailed description of the study of flavonoids.ResultsAfter analysis, the pharmacological effects of flavonoids on human cardiovascular system, digestive system, nervous system, immune system, and so on have a certain impact.The effect of flavonoids on the nervous system is mainly manifested in the analgesic, anti-inhibition and anti-aging.The antibacterial and antiviral effects of flavonoids are mainly antibacterial, antiviral activity and anti HIV activity.Flavonoids have good protective effects on liver injury, such as chemical liver injury, alcoholic liver injury, immunological liver injury, reperfusion liver injury and so on.Flavonoids can inhibit the growth and reproduction of tumor cells, and can promote the expression of tumor suppressor genes and promote the proliferation of tumor cells.The chemical structure of flavonoids is similar to that of estrogen, which is a kind of isoflavone, which has the physiological action of estrogen, and has a certain effect on estrogen.ConclusionThe flavone is extracted from various plants, belonging to the polyphenol compounds, with certain biological activity, were analyzed for the clinical application of its pharmacological action, has many applications of anti-inflammatory, anti-tumor, immunoregulation and liver protection and analgesic, a variety of biological activity, is widely applied in clinical.

Objective: To evaluate the nutritional markers in peritoneal dialysis patients. Methods: We examined SGA, dietary diaries, direct anthropometry, biochemical indices in 90 continuous ambulatory peritoneal dialysis (CAPD) patients. Then, the normalized protein equivalent of total nitrogen appearance (nPNA), lean body mass (LBM) and %LBM were calculated. Results: These patients were classified to three nutritional categories based on SGA (i.e. normal nutrition, mild to moderate malnutrition, severe malnutrition). The dietary protein intake(DPI), dietary energy intake(DEI), serum albumin(Alb), nPNA, LBM and %LBM were significantly different among three groups (P

Objective:To investigate the effects of soluble factors secreted by MCF-7 breast cancer cells on the differentiation,maturation and function of DCs.Methods:Mononuclear cells were cultured with the culture supernatants from primary MCF-7 cells.Combination of granulocyte-macrophage colony stimulating factor(GM-CSF),interleukin 4(IL-4) and tumor necrosis factor-a(TNF-a) was used to stimulate the cultured mononuclear cells.Then DCs and CTL assays were analyzed.Results:MCF-7 cell supernatant-treated DCs resulted in low expression of CD80,CD83,CD86 and HLA-DR,and the inhibition rate of CTL was 17.35% significantly lower than 56.14% induced by the control DCs(P＜0.01).IL-12 secreted by DCs and IFN-γ produced by PBMNC were all significantly lower than those in the control group (P＜0.01).Conclusion:Experiments in vitro shows that the culture supernatants from MCF-7 breast cancer cells could inhibit the development and functions of DCs.

Objective To compare the diagnostic values of different parameters for neonatal sepsis by observing clinical presentations and laboratory tests of hospitalized newborn infants and to find out the the early and fast way in neonatal sepsis diagnosis. Methods Newborn infants admitted to NICU from Sept.2007 to Feb.2008,who met all inclusion and exclusion criteria,were enrolled.The situations in perinatal period,exact time of the onset of infection,clinical manifestations and laboratory indexes were recorded.Infants were classified into 3 groups:septic group(n=13),nonseptic group(n=12) and noninfectious group(n=12).Sensitivity,specificity,false positive rate,false negative rate,Youden's index and positive and negative predictive values(PPV and NPV) were calculated for each test. Receiver-operating characteristic curves were analyzed to determine the optimal thresholds. Results Among all the clinical manifestations,abnormal reaction had the hightest specificity(84.6%) and accuracy(67.9%) in diagnosing neonatal sepsis.SIRS criteria,with the specificity of 95.8%,was helpful in clinical suspected eases.However,routine laboratory tests,such as WBC,PLT and GLU,had poor sensitivity or specificity;I/T had better specificity(100%),but was subject to discrepancy among different observers.The area under the ROC for CRP and PCT were 0.734 and 0.878,with the optimal threshold of 15 mg/L(P=0.020,Youden's index=45.5%) and 0.81 ng/ml(P-0.000,specificity=100%,Youden's index=75.0%),respectively.Conclusions Careful clinical inspection warrants early detection of sick infants.Evaluation of SIRS criteria in clinical suspected septic infants may help in early diagnosis.WBC,I/T,PLT can be used as routinely monitoring indexes for high risk neonates.CRP and PCT concentrations also have significant diagnostic values.

Objective To analyze distribution and drug resistance of MRSA separated,to probe into a treat method for MRSA infection and offer scientific gist for reasonable use of clinical antibiotic. Methods 568 MRSA separated from clinic were measured and a drug sensitivity test was performed by means of Kirby-Bautr agar diffusion method. Results 370 individual plants were filtered, the rate of inspection was 65.1%. MRSA was 36.2 % among them,MRSCON was 77.5% ,the drug resistance of MRSA to quinolones(21% ～48% ) was below MRSCON(84 %～89 % ). The drug resistance of MRSA and MRSCON obviously excelled MSSA and MSSCON ( P＜0.05 ). VRS was undiscovered. Conclusion Severe infection caused by MRS should choose vancomycin resistant enterococci to cure at fist. Staphylococcus was one of primary pathogenic bacterium caused infection in hospital, MRS had multiple drug resistance and measure range about drug resistance should be extended, which would advance the cognition about the drug resistance of antibiotic and cut off the transmitted path, reduce the drug resistance of bacteria and the infection rate in hospital.

Objective To investigate the relationship between human albumin stimulation and MCP-1 production of human renal tubular epithelial cells. Methods Thirteen patients with minimal change disease (MCD) were enrolled into the study. MCP-1 expression and M? infiltration in renal biopsy tissues were studied by immunohistochemistry (IHC) and in situ hybridization (ISH). In vitro experiment, proximal tubular epithelial HK-2 cells were stimulated by human serum albumin in different concentration, then MCP-1 production was detected by Western Blot. Results In renal tissues of MCD, focal positive MCP-1 was found in tubular walls and a few M infiltrated in every area including tubular walls , meanwhile a correlation of M? infiltration between interstitium and tubular lumen was studied. In cell culture experiment, with its concentration more than 2 g/L. human serum albumin could stimulate HK-2 cells to produce MCP-1. Conclusions MCP-1 expresses in the tubules of MCD patients with massive proteinuria. A few M?infiltrate in the renal tissue and move between the interstitium and the lumen of tubules. Human serum albumin can stimulate human tubular epithelial cells to produce MCP-1.

Objective To discuss the efficacy and safety analysis of different doses of low molecular weight heparin combined with hormone in the treatment of refractory nephrotic syndrome.Methods 60 cases of patients with refractory nephrotic syndrome in our hospital from January 2014 to January 2016 were selected,According to the random number table,60 patients were divided into high,medium and low dose of low molecular weight heparin group and control group,control group were treated with hormonal therapy,the high,medium and low dose of low molecular weight heparin group were injected low-molecular-weight heparin calcium on the basis of the control group,twice daily,once daily and every other day,respectively.Results After treatment,the clinical total effective rate of the high,medium and low dose group and control group patients was 14(93.3%),12(80.0%),10(66.7%) and 9(60.0%)respectively,the total efficiency of the high dose group was significantly higher than that of the control group(P<0.05),while there was no significant difference among control,medium and low dose group.The 24 h urine protein quantitation,ALB and Cr in high dose group improved better than those in medium and low dose group(P<0.05).The TG,TC and LDL in high dose group improved better than those in control group(P<0.05). The prothrombin time(PT)and activated partial thromboplastin time(APTT)in high and medium dose group were longer than those in control group(P<0.05),while fibrinogen(FIB)was lower(P<0.05).The PT in low dose group was longer than control group(P<0.05),while there was no significant difference in other coagulation indicators compared with control group.The APTT in high dose group was longer than low dose group(P<0.05).There was no obvious adverse reactions among each dose group.Conclusion The clinical curative effect in different doses of low molecular weight heparin combined with hormone in the treatment of refractory nephrotic syndrome is better,which could be significantly improved in patients with hypercoagulable state,especially effect of high dose group is more obvious.